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Organization

LIBERTY FAMILY CARE

Active
Parent organization
BAPTIST EASLEY HOSPITAL
Organization subpart
Yes

Provider details

NPI number
Legal business name
BAPTIST EASLEY HOSPITAL
Authorized official
MRS. BEVERLY B MERRY (PRACTICE ADMINISTRATOR)
(864) 843-5605
Entity
Organization

Contact information

Practice address
300 W FRONT ST, LIBERTY, SC 29657-1012
(864) 843-5605
(864) 843-0996
Mailing address
300 W FRONT ST, LIBERTY, SC 29657-1012
(864) 843-5605
(864) 843-0996

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1801028543
NPI-BAPTIST EASLEY-LIBERTY FAMILY CARE EFFECTIVE 10-1-2009
SC
01
GP2653
MEDICAID-PHBE-LFC INEFFECTIVE 9-30-2009
SC
01
GP5257
MEDICAID GRP-BAPTIST EASLEY -LIBERTY FAMILY CARE EFFECTIVE 10-1-2009
SC
Enumeration date
05/09/2006
Last updated
03/29/2010
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